Heat oil in large nonstick skillet over medium-high heat; add onion and cook, stirring occasionally, until light golden and tender, about 5 minutes. Add garlic; cook, stirring, until fragrant, 30 seconds.

Stir in tomatoes and water; bring to a boil over high heat. Reduce heat to low; simmer 3 minutes.

Stir in salt and crushed red pepper; gently stir in zucchini. Increase heat to medium high; cook, tossing frequently, until zucchini is tender, 5 minutes.

Stir in cream cheese until melted; remove from heat. Stir in basil; sprinkle with pecorino.